A short brief on 'Hospital Acquired Infections' (HAI) or 'Nosocomial Infection' (NI) for M Phil, MPH and Advance Course in Hospital Management/ Administration
A short brief on 'Hospital Acquired Infections' (HAI) or 'Nosocomial Infection' (NI) for M Phil, MPH and Advance Course in Hospital Management/ Administration
Pathogenic microorganisms proliferate and invade bodily tissue, causing tissue harm and disease.
The invasion and multiplication of microorganisms such as bacteria, viruses, and parasites those are not normally present within the body.
An infection may cause no symptoms and be subclinical, or it may cause symptoms and be clinically apparent.
An infection may remain localized, or it may spread through the blood or lymphatic vessels to become systemic (body wide).
Microorganisms that live naturally in the body are not considered infections.
For example, bacteria that normally live within the mouth and intestine are not infections.
Infection prevention policies and practices are used in hospitals and other health care facilities to reduce the spread of infections.
Infection prevention and control (IPC) is a practical, evidence-based approach which prevents health workers and patients from being harmed by avoidable infection and as a result of antimicrobial resistance.
INFECTION CONTROL NURSING - Agents of Nosocomial Infection - Modes of Transmi...Enoch Snowden
Infection control Nursing - Agents of Nosocomial Infection - Modes of Transmission - Infection Control Principles -GENERAL MEASURES TO REDUCE INFECTIONS - INFECTION CONTROL GUIDELINES/ POLICIES
Hospital infection control programs can help healthcare organizations monitor and improve practices, identify risks and proactively establish policies to prevent the spread of infections
Risk assessment must be considered whenever patient required for isolation
Type of isolation are source or protective
Tires of precautions include stander precaution and transmission based precaution which based on 3 mode of transmission contact, airborne, or droplets.
Hospital acquired infections: The different common sources of infection, their routes of spread and the growing antimicrobial resistance. Also includes a discussion on hospital Infection prevention and control guidelines and the universal and standard precautions.
Pathogenic microorganisms proliferate and invade bodily tissue, causing tissue harm and disease.
The invasion and multiplication of microorganisms such as bacteria, viruses, and parasites those are not normally present within the body.
An infection may cause no symptoms and be subclinical, or it may cause symptoms and be clinically apparent.
An infection may remain localized, or it may spread through the blood or lymphatic vessels to become systemic (body wide).
Microorganisms that live naturally in the body are not considered infections.
For example, bacteria that normally live within the mouth and intestine are not infections.
Infection prevention policies and practices are used in hospitals and other health care facilities to reduce the spread of infections.
Infection prevention and control (IPC) is a practical, evidence-based approach which prevents health workers and patients from being harmed by avoidable infection and as a result of antimicrobial resistance.
INFECTION CONTROL NURSING - Agents of Nosocomial Infection - Modes of Transmi...Enoch Snowden
Infection control Nursing - Agents of Nosocomial Infection - Modes of Transmission - Infection Control Principles -GENERAL MEASURES TO REDUCE INFECTIONS - INFECTION CONTROL GUIDELINES/ POLICIES
Hospital infection control programs can help healthcare organizations monitor and improve practices, identify risks and proactively establish policies to prevent the spread of infections
Risk assessment must be considered whenever patient required for isolation
Type of isolation are source or protective
Tires of precautions include stander precaution and transmission based precaution which based on 3 mode of transmission contact, airborne, or droplets.
Hospital acquired infections: The different common sources of infection, their routes of spread and the growing antimicrobial resistance. Also includes a discussion on hospital Infection prevention and control guidelines and the universal and standard precautions.
Over 1.4 million people each year worldwide suffer from hospital acquired infections. We can follow simple steps and protocols to prevent many of these cases.
description about asepsis, introduction, goal , meaning, types, principles.infection,chain of infection,breaking of infection,type of immunity ,nasocomial infection,universal precausions,body substances infection,post exposure prophylaxis etc.
Prevention of Surgical Site Infection- SSI [compatibility mode]drnahla
Infection Control Guidelines for Prevention of Surgical Site Infection- SSI
Dr. NAHLA ABDEL KADERوMD, PhD.
INFECTION CONTROL CONSULTANT, MOH
INFECTION CONTROL CBAHI SURVEYOR
Infection Control Director, KKH.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Infection control practices
1.
2. “Hospital acquired infections represent a serious and
growing health problem”
CDC – 2 million people acquire HAI every year
Mortality is about 90,000 as a result of infection
The Infection Control Committee was initiated on 1969
The study of efficacy of the Nosocomial infection was
initiated on 1985
3. Any infection that is not present or incubating at the
time of admission to the hospital
That is acquired more than 48 – 72 hrs after admission
and within 10 days after hospital discharge
HAI:
Lengthens hospital stay
Increases both mortality and morbidity
Total prevention is difficult and so control is
essential
4. Most common
Urinary Tract Infection (UTI) 20 – 25%
Due to indwelling urinary catheters
Respiratory tract infection 2nd
common
15 -20% related to respiratory devices
Surgical site infections 12%
Can occur incision and deep tissues of a wound
Blood stream infections-6%
Related to intravascular devices
5. Portal of
entry
into
host Mode of
transmission
Reservoir
Portalof
exit
from
reservoir
Susceptible
host
Causative agent
“Removing any one link breaks the chain
and prevents infection”
6. Causative agent:
Any microbe
Exogenous/endogenous
Reservoir:
Inanimate objects
Human beings
Animals
7. Portal of exit:
Respiratory
Genitourinary/ gastrointestinal
Skin/mucous membrane/placenta(mother to fetus)
Mode of transmission:
Easiest link to break
a) Contact transmission-Direct/indirect :
Hand washing is the most effective way to prevent
transmission by contact route
8. b) Droplet transmission:
Cough / sneeze
Influenza /whooping cough
c) Air borne transmission:
PTB / Varicella / Measles
Portal of entry:
Usually same as portal of exit
9. Age factor
Poor health status
Immuno compromised
Invasive diagnostic tests
Use of broad spectrum antibiotics
10. Elimination of infectious agent
- Isolation of the patient
- Barrier precautions
- Effective disinfection and sterilization of equipments
- Cleaning of environment
11. All patients are potentially infectious
Wear gloves – blood, body fluid and contaminated
items
Wash hands frequently with soap or hand rub
Patient care equipments – Disposable – Discard
- Reusable – decontaminate
Proper sharps disposal
Spills – clean with bleach or 1:10 Sodium hypochlorite
solution
12. MRSA, Pseudomonas, ESBL producers, Salmonella/
Shigella
GI tract infections/skin infections
Patient to be isolated in private rooms
Wear gloves when entering the room
Wear mask and goggles – blood and body fluids
13. Isolate in private room or spatial separation of 3 feet
PPE is essential
When transporting, surgical mask to be provided to
patients
Pneumonia, Pertussis, Influenzae, virus, RSV
14. Private room with negative air pressure
Person entering the isolation room should wear
respirator mask
PTB / Measles / Varicella
15. Instruments used in diagnostic/therapeutic procedures
need
- Thorough mechanical cleaning
- Proper sterilization
- Rinsing with sterile water
- Proper drying
Disinfection
- Use of disinfectants
- Follow manufacturers instructions (MSDS)expiry date to
be
checked
- Do not refill containers
- Do not use empty containers for storing other solutions
16. Antibiotic Policy:
Undue usage of antibiotics
Emergence of MDR strains
Strict “Antibiotic Policy” is essential
Undue usage - Emergence of MDR strains
Antibiotic policy is a must
Restrictive Rotational
17. Hospital Personnel:
Hospital staff- potential sources of infection
Monitoring – kitchen staff
Units with high risk patients – bacteriological
monitoring
Employee Health Care:
Hospital employees in high-risk areas, Staff and Doctors
to be given Hep ‘B’ vaccination – 3 doses
Education program in Infection Control policies &
practices
18. Occupational Exposure Form
To be strictly maintained
Sharp injury – needs thorough washing
Assessment of patient status – HBsAg, HCV & HIV
HCW status assessment & necessary action
Counselling
19. Supporting development of an effective infection
control programme
Develop policies and procedures
Occupational health and safety
Education & Training
20. Infection Control
Committee
Hosp. Epidemiologist
Inf. Con. Practitioner.
Clinical Microbiologist
Epidemiology Nurse
(Infection Control
Nurse)
Policies &
Regulations
Members from other
departments
Medical Director &
Administrative Head
Regular Monitoring
Continuing
Education
Surveillance
21. Plays an essential role
Good working relationship with clinicians
Report antibiograms of organisms
Monitoring MDR ,MRSA, VRE organisms
Identify pseudo & true out breaks
Perform surveillance cultures
22. Foundation for organizing &maintaining an effective
infection control programme
Useful for Infection Control Team and Infection
control committee in identifying areas of priority &
allocating resources accordingly
23. Main objectives of surveillance
Reducing infection rates within healthcare facilities
Establishing endemic infections rates
Identifying outbreaks
Convincing medical personnel to adopt recommended
preventive practices
Comparing infection rates between health care
establishments
Evaluating infection control measures
24. 1. Continuous surveillance
Entire health care facility
Time consuming & not cost effective
2. Targetted surveillance
High risk areas
More effective and manageable
25. Name, age & sex
Date of birth
Hospital record number
Ward or unit in the hospital
Name of the consultant
Unit involved
Date of admission
Date of discharge or death
Site of infection
Organism isolated with antibiotic sensitivity
26. “Occurrence of disease at a rate greater than that
expected within a
specific geographical area & over a defined period of
time”
Management:
Communicate to relevant staff
Laboratory support for effective investigations
AST and molecular typing is essential
Stocking outbreak isolates
Take immediate control measures
Monitor the effectiveness of control measures
27. Screen personnel and environment
Write a coherent report
Summarize investigations & Recommendations to
appropriate authorities
Implement long term infection control measures for
prevention of similar outbreaks
29. SSI are considered to be nosocomial if the infection
occurs within 30 days of operative procedure or within
a year if a device or foreign material is implanted
Third common HAI
30. Host related Procedure related
Age
Obesity
Disease severity
Nasal carriage of Staph.aureus
Duration of pre-operative
hospitalization
Mal nutrition
Diabetes mellitus
Malignancy
Immuno suppressive therapy
Pre-operative hair removal
Type of procedure
Antibiotic prophylaxis
Duration of surgery
Multiple procedures
Tissue trauma
Foreign material
Blood transfusion
Pre-operative showers
Emergency surgery
Drains
32. Class 1 - Clean wound
Class 2 - Clean contaminated wounds
Class 3 - Contaminated wounds
Class 4 - Dirty wounds
33. Class 1 - Clean Wound:
When operative procedures does not enter in to hollow
viscus or lumen of the body
SSI rates - < 2%
Originates from the contaminants in the operating room
environment
From surgical team or most commonly skin
34. Class 2 - Clean Contaminated Wound:
When the operative procedure enters into colonized
viscus or cavity of the body but under elective or
controlled circumstances
SSI rate – 4-10%
Class 3 - Contaminated Wound:
When gross contamination is present but no infection is
obvious a surgical site is said to be contaminated
SSI rate – can exceed 20%
Contaminants are bacteria that are introduced by soilage
of surgical field
35. Class 4 - Dirty Wounds:
If an infection is already present in the surgical site it is
considered to be dirty
Pathogens of active infection as well as unusual
pathogens are likely be encountered
SSI rates - > 40%
37. Infection occurs within 30 days from surgery and
involves only skin or subcutaneous tissue and atleast
one of the following:
1. Purulent discharge, with or without lab confirmation,
from the superficial incision
2. Organisms isolated from an aseptically obtained
culture of fluid or tissue from the superficial incision
3. At least one of the signs or symptoms of infection
4. Diagnosis of SSI by the surgeon
5. Infection that extends into fascial and muscle layers
should not be taken as superficial incisional SSI
38. Infection occurs within 30 days after the operation if
no implant is left in the place or within 1 year if
implant is in place
Infection involves deep soft tissues
Involves one of the following:
Purulent discharge from deep incision
Spontaneously dehisces or delibrately opened by
surgeon when the patients has signs and symptoms
An abscess or other evidence of infection involving
deep incision or during re-operation
39. Infection occurs within 30 days after the operation if no
implant is left in the place or within 1 year if implant is in
place
Infection involves any part of the anatomy other than
incision which was opened or manipulated during an
operation
Involves the following:
Purulent drainage from the drain i.e., placed through a stab
wound in to organ/space
Organism isolated from aseptically obtained culture of
fluid or tissue
An abscess or other evidence of infection involving deep
incision or during re-operation
40. Pre operative showers
- decreases infection rates in patients when showered
with antiseptic solution
Pre operative hospitalization
- should be kept to minimum before surgery
- longer the stay increase in SSI rates
Pre-operative shaving
- should be avoided (Skin bruises and trauma)
- Increase the risk of SSI
- Depilatory cream – decreased SSI
- but causes skin irritation and rashes
41. Improvement in timing of initial administration
Appropriate choice of antibiotic
Short duration of administration
Prophylactic antibiotic is indicated in class 1,2,3
Therapeutic antibiotic is indicated in class 4
42. Principle of surgical asepsis must be followed
Appropriate skin disinfectants should be used
Clothing contaminated with blood of body fluids
should be removed as soon as possible and bagged
Wear fluid repellent high efficiency mask during
procedures
Gloves, mask, goggles, face shields, closed foot wear
43. Antiseptic skin preparation
- applied with friction in concentric circles
- moving away from proposed incisional site to periphery
well beyond operating site
Sterile drapes used in OT should be impervious
Staff movement should be minimal
44. Wound dressing
- Appropriate training for the staff is essential
- minimal frequency of dressing
- Dressings should not be opened for 48 hours after surgery
unless
infection is suspected
Theatre acquired infection
- Deep seated
- Occurs within 3 days of surgery or before first dressing
- Many infections may not be recognized for weeks or months
particularly after prosthetic surgery
45. Post operative stay:
Avoid prolonged post operative stay
Avoid overcrowding in wards
If any medical reasons keep the patient in clean
environment to protect them from colonization
Environmental cleaning of OT
Floor should be cleaned at the end of each session and
scrubbed daily
Spillages should be disinfected and removed as soon as
possible
Lint free cloth is recommended for all operating theatres
46. Infection control programs focus on identifying high
risk procedures and other possible sources of infection.
High risk procedures should be performed only when
necessary
Proper sterilization of instruments
Frequent hand washing
Strict antibiotic policy